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AIDS cholangiopathy

A Misra¹, R Gupta, S L Broor

¹Department of Gastroenterology, G B Pant Hospital, New Delhi.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology

|August 8, 1998

Summary

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A 45-year-old man with unexplained diarrhea and weight loss was diagnosed with Human Immunodeficiency Virus (HIV). His biliary system showed significant dilation and strictures, despite no opportunistic infections being identified.

Area of Science:

Gastroenterology
Hepatology
Infectious Diseases

Background:

Biliary tract disease can present with non-specific gastrointestinal symptoms.
Human Immunodeficiency Virus (HIV) infection can be associated with various opportunistic and non-opportunistic conditions affecting multiple organ systems.

Observation:

A 45-year-old male presented with a year of diarrhea and significant weight loss.
Elevated serum alkaline phosphatase and ultrasonography revealed dilated intrahepatic biliary ducts and the upper common bile duct (CBD).

Findings:

Endoscopic Retrograde Cholangiopancreatography (ERCP) demonstrated papillary stenosis, a dilated CBD, a stricture at the biliary confluence, and saccular dilatation of left intrahepatic ducts.
The patient was diagnosed as HIV-positive.

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Despite extensive investigations including duodenal biopsy, rectal biopsy, and stool examination, no opportunistic organisms were identified as the cause of the biliary findings.

Implications:

This case highlights a rare presentation of biliary tract disease in an HIV-positive individual.
The findings suggest a potential link between HIV and biliary abnormalities, even in the absence of typical opportunistic infections.
Further research is warranted to understand the pathogenesis and management of such conditions in immunocompromised patients.